A model based on adipose and muscle-related indicators evaluated by CT images for predicting microvascular invasion in HCC patients

© 2023. Yumed Inc. and BioMed Central Ltd., part of Springer Nature..

BACKGROUND AND AIM: The presence of microvascular invasion (MVI) will impair the surgical outcome of hepatocellular carcinoma (HCC). Adipose and muscle tissues have been confirmed to be associated with the prognosis of HCC. We aimed to develop and validate a nomogram based on adipose and muscle related-variables for preoperative prediction of MVI in HCC.

METHODS: One hundred fifty-eight HCC patients from institution A (training cohort) and 53 HCC patients from institution B (validation cohort) were included, all of whom underwent preoperative CT scan and curative resection with confirmed pathological diagnoses. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied to data dimensionality reduction and screening. Nomogram was constructed based on the independent variables, and evaluated by external validation, calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA).

RESULTS: Histopathologically identified MVI was found in 101 of 211 patients (47.9%). The preoperative imaging and clinical variables associated with MVI were visceral adipose tissue (VAT) density, intramuscular adipose tissue index (IMATI), skeletal muscle (SM) area, age, tumor size and cirrhosis. Incorporating these 6 factors, the nomogram achieved good concordance index of 0.79 (95%CI: 0.72-0.86) and 0.75 (95%CI: 0.62-0.89) in training and validation cohorts, respectively. In addition, calibration curve exhibited good consistency between predicted and actual MVI probabilities. ROC curve and DCA of the nomogram showed superior performance than that of models only depended on clinical or imaging variables. Based on the nomogram score, patients were divided into high (> 273.8) and low (< = 273.8) risk of MVI presence groups. For patients with high MVI risk, wide-margin resection or anatomical resection could significantly improve the 2-year recurrence free survival.

CONCLUSION: By combining 6 preoperative independently predictive factors of MVI, a nomogram was constructed. This model provides an optimal preoperative estimation of MVI risk in HCC patients, and may help to stratify high-risk individuals and optimize clinical decision making.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:11

Enthalten in:

Biomarker research - 11(2023), 1 vom: 04. Okt., Seite 87

Sprache:

Englisch

Beteiligte Personen:

Mao, Xin-Cheng [VerfasserIn]
Shi, Shuo [VerfasserIn]
Yan, Lun-Jie [VerfasserIn]
Wang, Han-Chao [VerfasserIn]
Ding, Zi-Niu [VerfasserIn]
Liu, Hui [VerfasserIn]
Pan, Guo-Qiang [VerfasserIn]
Zhang, Xiao [VerfasserIn]
Han, Cheng-Long [VerfasserIn]
Tian, Bao-Wen [VerfasserIn]
Wang, Dong-Xu [VerfasserIn]
Tan, Si-Yu [VerfasserIn]
Dong, Zhao-Ru [VerfasserIn]
Yan, Yu-Chuan [VerfasserIn]
Li, Tao [VerfasserIn]

Links:

Volltext

Themen:

Adipose and muscle tissues
Computed tomography
Hepatocellular carcinoma
Journal Article
Microvascular invasion
Nomogram
Survival analysis

Anmerkungen:

Date Revised 23.11.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1186/s40364-023-00527-z

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM362882355